U.S. patent application number 15/207026 was filed with the patent office on 2016-11-03 for retractor with modular handles.
This patent application is currently assigned to Life Spine, Inc.. The applicant listed for this patent is Life Spine, Inc.. Invention is credited to Michael S. Butler, Daniel Predick.
Application Number | 20160317137 15/207026 |
Document ID | / |
Family ID | 57203976 |
Filed Date | 2016-11-03 |
United States Patent
Application |
20160317137 |
Kind Code |
A1 |
Predick; Daniel ; et
al. |
November 3, 2016 |
RETRACTOR WITH MODULAR HANDLES
Abstract
A retractor assembly includes a base; a first side arm assembly
coupled to a first side of the base and configured to translate
relative to the base along a first direction; a second side arm
assembly coupled to a second side of the base and configured to
translate relative to the base along the first direction
independent from the first side arm assembly; and a central arm
assembly coupled to a center portion of the base and configured to
translate relative to the base along a second direction different
from the first direction.
Inventors: |
Predick; Daniel; (Chicago,
IL) ; Butler; Michael S.; (St. Charles, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Life Spine, Inc. |
Huntley |
IL |
US |
|
|
Assignee: |
Life Spine, Inc.
Huntley
IL
|
Family ID: |
57203976 |
Appl. No.: |
15/207026 |
Filed: |
July 11, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14874073 |
Oct 2, 2015 |
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15207026 |
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13720800 |
Dec 19, 2012 |
9386916 |
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14874073 |
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61577857 |
Dec 20, 2011 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/0206
20130101 |
International
Class: |
A61B 17/02 20060101
A61B017/02 |
Claims
1. A retractor assembly, comprising: a base; a first side arm
assembly coupled to a first side of the base and configured to
translate relative to the base along a first direction based on
rotation of a first drive shaft positioned at a first angle
relative to the first direction; a second side arm assembly coupled
to a second side of the base and configured to translate relative
to the base along the first direction independent from the first
side arm assembly and based on rotation of a second drive shaft
positioned at a second angle relative to the first direction; and a
central arm assembly coupled to a center portion of the base and
configured to translate relative to the base along a second
direction different from the first direction based on rotation of a
third drive shaft positioned at a third angle relative to the
second direction.
2. The retractor assembly of claim 1, wherein the first side
assembly translates along a first threaded shaft disposed within
the base; wherein the second side assembly translates along a
second threaded shaft disposed within the base; and wherein the
center assembly translates along a third threaded shaft disposed
within the base.
3. The retractor assembly of claim 2, further comprising: a first
adjustment knob operatively coupled to the first threaded shaft via
a first multi-axis joint; a second adjustment knob operatively
coupled to the second threaded shaft via a second multi-axis joint;
and a third adjustment knob operatively coupled to the third
threaded shaft via a third multi-axis joint.
4. The retractor assembly of claim 3, further comprising: a first
adjustment handle removably attachable to the first adjustment
knob, wherein the first adjustment knob is coupled to the first
drive shaft via a first pivot pin that permits relative rotation
between the first adjustment knob and the first drive shaft; a
second adjustment handle removably attachable to the second
adjustment knob, wherein the second adjustment knob is coupled to
the second drive shaft via a second pivot pin that permits relative
rotation between the second adjustment knob and the second drive
shaft; and a third adjustment handle removably attachable to the
third adjustment knob, wherein the third adjustment knob is coupled
to the third drive shaft via a third pivot pin that permits
relative rotation between the third adjustment knob and the third
drive shaft.
5. The retractor assembly of claim 3, wherein each of the first,
second, and third multi-axis joints includes at least one of a ball
joint and a universal joint.
6. The retractor assembly of claim 1, further comprising a support
handle removably coupled to the base and extending along the second
direction.
7. The retractor assembly of claim 6, wherein the support handle
comprises a plurality of gripping members extending about at least
a portion of the periphery of the support handle and an interior
portion defining a handle aperture.
8. The retractor assembly of claim 6, wherein the base includes an
attachment groove configured to slidably receive an attachment
portion of the support handle.
9. The retractor assembly of claim 8, wherein the attachment
portion of the handle includes a spring-biased locking plate having
a projection configured to releasably engage a recess provided on
the base.
10. A retractor assembly, comprising: a base; a first side arm
assembly coupled to a first side of the base and configured to
translate relative to the base along a first direction; a second
side arm assembly coupled to a second side of the base and
configured to translate relative to the base along the first
direction; and a center arm assembly coupled to a center portion of
the base and configured to translate relative to the base along a
second direction different from the first direction; wherein each
of the first side arm assembly, the second side arm assembly, and
the center arm assembly is coupled to the base by an adjustment
mechanism including a multi-axis joint assembly.
11. The retractor assembly of claim 10, wherein the adjustment
mechanism includes a threaded shaft disposed within the base,
wherein the multi-axis joint assembly includes a drive shaft
coupled to the threaded shaft via a ball received within a
receiver.
12. The retractor assembly of claim 11, wherein the adjustment
mechanism includes: an adjustment knob coupled to the drive shaft
via a pivot pin; and an adjustment handle removably coupled to the
adjustment knob.
13. The retractor assembly of claim 10, wherein the first side arm
assembly translates along a first threaded shaft, the second side
arm assembly translates along a second threaded shaft, and the
center arm assembly translates along a third threaded shaft, and
wherein first threaded shaft and the second threaded shaft define a
first axis, and wherein the third threaded shaft defines a second
axis intersecting the first axis.
14. The retractor assembly of claim 13, wherein each of the first
threaded shaft, the second threaded shaft, and the third threaded
shaft is rotatable relative to the base and translationally fixed
relative to the base.
15. The retractor assembly of claim 10, further comprising a
support handle removably coupled to the base and extending along
the second direction.
16. The retractor assembly of claim 15, wherein an attachment
portion of the support handle includes a spring-biased locking
plate having a projection configured to releasably engage a recess
provided on the base.
17. A method of operating a retractor, comprising: placing a
retractor into a desired position, wherein the retractor includes a
frame, a first side assembly, a second side assembly, and a center
assembly; translating the first side assembly relative to the frame
along a first threaded shaft and independent from the second side
assembly and the center assembly by rotating a first knob coupled
to the first threaded shaft via a first joint assembly; translating
the second side assembly relative to the frame along a second
threaded shaft and independent from the first side assembly and the
center assembly by rotating a second knob coupled to the second
threaded shaft via a second joint assembly; and translating the
center assembly relative to the frame along a third threaded shaft
and independent from the first side assembly and the second side
assembly by rotating a third knob coupled to the third threaded
shaft via a third joint assembly.
18. The method of claim 17, further comprising attaching a
removable adjustment handle to each of the first, second, and third
adjustment knobs.
19. The method of claim 17, further comprising releasably attaching
a support handle to the frame.
20. The method of claim 19, wherein an attachment portion of the
support handle includes a spring-biased locking plate having a
projection configured to releasably engage a recess provided on the
frame.
Description
CROSS-REFERENCE TO RELATED PATENT APPLICATIONS
[0001] This application is a continuation-in-part of application
Ser. No. 14/874,073, filed Oct. 2, 2015, which is a
continuation-in-part of application Ser. No. 13/720,800, filed Dec.
19, 2012, which claims the benefit of Provisional Application No.
61/577,857 filed Dec. 20, 2011. The entire contents of all of these
applications are incorporated herein by reference.
BACKGROUND
[0002] The present invention relates to surgical devices for
retracting anatomy to provide exposure of an operating site, and
more particularly, to retraction apparatus providing improved
access to a surgical site for a spine procedure.
[0003] Surgical procedures typically require the use of a retractor
to hold anatomies and/or tissues out of the way from the incision
down to the actual surgical site. In the case of posterior spinal
surgery for implanting various spine fixation components and/or
other spinal orthopedic devices, it is necessary to retract
different tissue types including large and strong paraspinal
muscles in order to get to the actual surgical site. In order to
accomplish this goal, spinal retractors have been developed that
hold back the desired anatomy of a spinal surgical site and is
fixed relative to the patient either directly or indirectly.
[0004] Many different types of spinal retractors are currently
available many of which use retractor blades--a part of the
distraction mechanism of the spinal retractor that enters the site
of the incision and physically holds the anatomy apart. The
retractor blades can be attached to a frame at an angle such as
about 90 degrees from horizontal (i.e. generally vertical) or as to
have a variable angle. However, current spinal retractors have
various deficiencies. For instance, fixed angle retractor blade
configurations limit flexibility of the spinal retractor, including
loss of surgical site precision and overall stabilization. The
variable angle retractor blade configurations lack preciseness and
flexibility in retractor blade positioning.
[0005] It is therefore evident from the above that there is a need
for an improved spinal retractor that can overcome the deficiencies
of current spinal retractors. It is also evident from the above
that there is a need for an improved spinal retractor which
provides enhanced preciseness and flexibility in retractor blade
positioning. It is furthermore evident that there is a need for an
improved spinal retractor as aforementioned which also allows for
instrument and/or component retention and positioning by the
retractor blade assembly.
SUMMARY
[0006] The present disclosure relates to a spinal retractor for
spinal surgeries providing improved preciseness and stability in
positioning, tissue distraction, and surgical site access. The
spinal retractor utilizes adjustable and lockable translating arms
with angulating blades to provide a stable surgical site finestra
and the adjustable retraction of surgical site tissue.
[0007] The present spinal retractor is a three blade retractor that
allows triangulated medial/lateral and cephalad/caudal tissue
retraction for spinal surgeries via the adjustably lockable
translating arms. A medial/lateral translating arm with an
angularly adjustable retraction blade co-acts and cooperates with
angularly adjacent first and second cephalad/caudal translating
arms with angularly adjustable retraction blades for tissue
retraction and surgical site access.
[0008] The spinal retractor includes a plate having a
medial/lateral adjustment system adjustably holding the
medial/lateral translating arm, a first cephalad/caudal adjustment
system adjustably holding the first cephalad/caudal translating
arm, and a second cephalad/caudal adjustment system adjustably
holding the second cephalad/caudal translating arm. The translating
arms each have a blade holder which provides angular adjustment of
the blade. Angular adjustment of each blade along with
medial/lateral and cephalad/caudal adjustment provides improved
preciseness and stability in positioning, tissue distraction, and
surgical site access.
[0009] Another embodiment relates to a retractor assembly,
including a base, a first side arm assembly coupled to a first side
of the base, a second side arm assembly coupled to a second side of
the base, and a central arm assembly coupled to a center portion of
the base. The first side arm is configured to translate relative to
the base along a first direction based on rotation of a first drive
shaft positioned at a first angle relative to the first direction.
The second arm is configured to translate relative to the base
along the first direction independent from the first side arm
assembly and based on rotation of a second drive shaft positioned
at a second angle relative to the first direction. The central arm
is configured to translate relative to the base along a second
direction different from the first direction based on rotation of a
third drive shaft positioned at a third angle relative to the
second direction.
[0010] Another embodiment relates to a retractor assembly,
including a base, a first side arm assembly coupled to a first side
of the base, a second side arm assembly coupled to a second side of
the base, and a center arm assembly coupled to a central portion of
the base. The first side arm assembly is configured to translate
relative to the base along a first direction. The second side arm
assembly is configured to translate relative to the base along the
first direction. The center arm assembly is configured to translate
relative to the base along a second direction different from the
first direction. Each of the first side arm assembly, the second
side arm assembly, and the center arm assembly is coupled to the
base by an adjustment mechanism including a multi-joint joint
assembly.
[0011] Another embodiment relates to a method of operating a
retractor. The method includes placing a retractor into a desired
position, wherein the retractor includes a frame, a first side
assembly, a second side assembly, and a center assembly. The method
further includes translating the first side assembly relative to
the frame along a first threaded shaft and independent from the
second side assembly and the center assembly by rotating a first
knob coupled to the first threaded shaft via a first joint
assembly. The method further includes translating the second side
assembly relative to the frame along a second threaded shaft and
independent from the first side assembly and the center assembly by
rotating a second knob coupled to the second threaded shaft via a
second joint assembly. The method further includes translating the
center assembly relative to the frame along a third threaded shaft
and independent from the first side assembly and the second side
assembly by rotating a third knob coupled to the third threaded
shaft via a third joint assembly.
[0012] Further aspects of the present disclosure will become
apparent from consideration of the drawings and the following
description of various embodiments. A person skilled in the art
will realize that other embodiments are possible and that the
details can be modified in a number of respects without departing
from the inventive concepts disclosed herein. The following
drawings and description are to be regarded as illustrative in
nature and not restrictive.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The features of the present disclosure will be better
understood by reference to the accompanying drawings which
illustrate various embodiments, wherein:
[0014] FIG. 1 is a topside view of a spinal retractor fashioned in
accordance with the present principles, the spinal retractor shown
in a closed position;
[0015] FIG. 2 is an underside view of the spinal retractor of FIG.
1 shown in a closed position;
[0016] FIG. 3 is another topside view of the spinal retractor of
FIG. 1 in an open position;
[0017] FIG. 4 is a top plan view of the spinal retractor of FIG. 1
in a closed position; and
[0018] FIG. 5 is an enlarged topside view of a blade assembly on an
arm of the spinal retractor of FIG. 1.
[0019] FIG. 6 is a perspective view of a spinal retractor according
to an alternative embodiment.
[0020] FIG. 7 is a top view of the spinal retractor assembly of
FIG. 6 according to one embodiment.
[0021] FIG. 8 is a front view of the spinal retractor assembly of
FIG. 6 according to one embodiment.
[0022] FIG. 9 is a cross-sectional view taken along line 9-9 of
FIG. 8 according to one embodiment.
[0023] FIG. 10 is a cross-sectional perspective view taken along
line 10-10 of FIG. 7 according to one embodiment.
[0024] FIG. 11 is a perspective view of a spinal retractor in a
closed configuration according to one embodiment.
[0025] FIG. 12 is a perspective view of the spinal retractor of
FIG. 11 in an open configuration according to one embodiment.
[0026] FIG. 13 is a perspective view of the spinal retractor of
FIG. 11 in an open configuration with angulated blades according to
one embodiment.
[0027] FIG. 14 is an exploded view of the spinal retractor of FIG.
6 according to one embodiment.
[0028] FIGS. 15A-15B illustrate a side assembly of a spinal
retractor according to one embodiment.
[0029] FIGS. 16A-16B illustrate a central assembly of a spinal
retractor according to one embodiment.
[0030] FIG. 17 is a perspective view of a portion of a spinal
retractor according to one embodiment.
[0031] FIGS. 18A-19B illustrate various portions of a spinal
retractor according to one embodiment.
[0032] FIGS. 20A-21C illustrate a blade for a spinal retractor
according to one embodiment.
[0033] FIG. 22 is a perspective view of a spinal retractor
according to another embodiment.
[0034] FIGS. 23-24 are additional perspective views of the spinal
retractor of FIG. 22 according to one embodiment.
[0035] FIGS. 25-26 are perspective views of portions of the spinal
retractor of FIG. 22 according to one embodiment.
[0036] FIG. 27 is a perspective view of the spinal retractor of
FIG. 22 with various handles attached according to one
embodiment.
[0037] FIG. 28 is a perspective view of the spinal retractor of
FIG. 22 with a support handle attached according to one
embodiment.
[0038] FIG. 29 is a perspective cross-sectional view of the spinal
retractor of FIG. 22 taken along line A-A of FIG. 28 according to
one embodiment.
[0039] FIG. 30 is an exploded view of a portion of a spinal
retractor according to one embodiment.
[0040] FIGS. 31A-32C are various views of primary and secondary
blades according to various exemplary embodiments.
[0041] Like reference numbers indicate the same or similar parts
throughout the several figures.
[0042] A description of the features, functions and/or
configurations of the components depicted in the various figures
will now be presented. It should be appreciated that not all of the
features of the components of the figures are necessarily
described. Some of these non-discussed features as well as
discussed features are inherent from the figures. Other
non-discussed features may be inherent in component geometry and/or
configuration.
DETAILED DESCRIPTION
[0043] Reference is now made to FIGS. 1-5 which depict several
views of a spinal retractor 10, fashioned in accordance with the
present principles. The spinal retractor 10 is fashioned for use in
anterior, posterior and lateral spinal surgeries or procedures,
such as orthopedic implantation, vertebral fixation and vertebral
stabilization, but may be used in other surgical procedures and
orientations. The spinal retractor 10 is formed of an appropriate
surgical material such as titanium, stainless steel, an alloy of
same or the like.
[0044] The spinal retractor 10 has a body 12 characterized by a
base, plate, platform or the like 13, a first translating arm 14
carried by the base 13 on one side thereof, a second translating
arm 16 carried by the base 13 on another side thereof, wherein the
sides are in the cephalad/caudal direction when the spinal
retractor 10 is used, and a middle arm 18 carried by the base
between the first and second translating arms 14, 16, wherein the
middle arm is in the lateral/medial direction when the spinal
retractor 10 is used. The base 13 further has a first side arm or
wing 24 extending from a first side of the base 13 and a second
side arm or wing 26 extending from a second side of the base 13.
The first and second side arms 24, 26 extend generally in opposite
directions relative to each other but with a slight inward angle as
shown. The first and second side arms 24, 26 are in the
cephalad/caudal direction when the spinal retractor 10 is used.
[0045] The spinal retractor 10 is designed to be fixed relative to
a surgical site particularly, but not necessarily, to an external
frame or the like (not shown) that is fixed relative to the
patient. The spinal retractor 10 is also configured for rotation
relative to the external frame. As such the base 13 has a boss 22
situated between opposite edges 25, 27, the boss 22 defining a face
23 from which projects a post, shaft, pole, bar, rod, stick or the
like (i.e. a projection) 21. The spinal retractor 10 is connected
with the external frame via the projection 21 which is received in
or by a clamp, holder, receiver or the like (not shown) of the
external frame. The projection 21 has a textured or keyed outer
surface for engagement with the external frame, shown in the
figures as radially spaced longitudinal grooves. The external
surface of the projection 21 aids in positive engagement of the
spinal retractor 10 with the external frame in order to fix
rotational position of the spinal retractor 10 relative to the
external frame.
[0046] A housing 28 is disposed on the base 13 between the first
and second side arms 24, 26 and has an opening that receives the
arm 18. The housing 28 cooperates with the arm 18 to provide
adjustment of the arm 18 relative to the housing 28. Particularly,
the arm 18 has a plurality of teeth, serrations or the like 51 on
an inside edge thereof while the housing 28 includes ratchet
components that cooperate with the teeth 51 of the arm 18 to
provide ratcheting adjustability/translation of the arm 18 relative
to the base 13. A button 29 is associated with the housing 28 and
is coupled to the internal ratchet components thereof in order to
allow release of the ratcheted (fixed) position of the arm 18
relative to the housing 28. In this manner, the arm 18 translates
or slides in and out relative to the housing 28/base 13.
Additionally, since a blade assembly 48, as described more fully
below, is connected to the arm 18, the blade assembly 48 translates
relative to the housing 28/base 13. This allows the blade assembly
48 to be positioned relative to the housing 28/base 13 and to the
other blade assemblies 50, 52. Because of its position, the arm 18
and thus the blade assembly 48 translate or move in the
medial/lateral directions when the spinal retractor 10 is in use.
Position of the blade assembly 48 affects and effects retraction of
tissue at the surgical site, particularly in the medial/lateral
directions.
[0047] A housing 30 is disposed on an end of the first side arm 24
and has an opening that receives the first translating arm 14. The
housing 30 cooperates with the first translating arm 14 to provide
adjustment of the first translating arm 14 relative to the housing
30. Particularly, the first translating arm 14 has a plurality of
teeth, serrations or the like 41 on an inside edge of an end 39 of
the first translating arm 14 while the housing 30 includes ratchet
components that cooperate with the teeth 41 of the first
translating arm 14 to provide ratcheting adjustability/translation
of the first translating arm 14 relative to the first side arm
24/base 13. A button 31 is associated with the housing 30 and is
coupled to the internal ratchet components thereof in order to
allow release of the ratcheted (fixed) position of the first
translating arm 14 relative to the housing 30. In this manner, the
first translating arm 14 translates or slides in and out relative
to the housing 30/first side arm 24. Additionally, since the blade
assembly 50, as described more fully below, is connected to the
first translating arm 14, the blade assembly 50 translates relative
to the housing 30/first side arm 24. This allows the blade assembly
50 to be positioned relative to the housing 30/first side arm 24
and to the other blade assemblies 48, 52.
[0048] Mention is now made to the configuration of the first
translating arm 14. The first translating arm 14 is angled or bent
so as to define a "boomerang" shape--i.e. an elbow or bend 38
between arm segments 36 and 39. Particularly, arm segments 36, 39
are bent to have an internal angle of less than ninety degrees
(angle <90.degree.) with around seventy degrees (70.degree.)
being shown and preferred. Other angles, of course, may be used. A
head 37 is provided at an end of the arm segment 36 opposite the
bend 38 and is angled so as to project essentially parallel with
the arm segment 39. The head 37 holds the blade assembly 50. As
seen, the first translating arm 14 is angled so that its blade
assembly 50 is proximate the blade assembly 48 of the arm 18.
[0049] The first translating arm 14 moves in and out relative to
the housing 30 and thus the first side arm 24 through ratcheting of
the arm segment 39 with its plurality of teeth 41 cooperating with
the ratchet components of the housing 30. Movement of the arm 14
moves the corresponding blade assembly 50 relative to the other
blade assemblies 48, 52. Because of its position and connection
with the housing 30, the first translating arm 14 translates or
moves in the cephalad/caudal directions so that the blade assembly
50 also moves in the cephalad/caudal directions. Position of the
blade assembly 50 affects and effects retraction of tissue at the
surgical site, particularly in the cephalad/caudal directions.
[0050] A housing 32 is disposed on an end of the second side arm 26
and has an opening that receives the second translating arm 16. The
housing 32 cooperates with the second translating arm 16 to provide
adjustment of the second translating arm 16 relative to the housing
32. Particularly, the second translating arm 16 has a plurality of
teeth, serrations or the like 47 on an inside edge of an end 45 of
the second translating arm 16 while the housing 32 includes ratchet
components that cooperate with the teeth 47 of the second
translating arm 16 to provide ratcheting adjustability/translation
of the second translating arm 16 relative to the second side arm
26/base 13. A button 32 is associated with the housing 32 and is
coupled to the internal ratchet components thereof in order to
allow release of the ratcheted (fixed) position of the second
translating arm 16 relative to the housing 32. In this manner, the
second translating arm 16 translates or slides in and out relative
to the housing 32/second side arm 26. Additionally, since the blade
assembly 52, as described more fully below, is connected to the
second translating arm 16, the blade assembly 52 translates
relative to the housing 32/second side arm 26. This allows the
blade assembly 52 to be positioned relative to the housing
32/second side arm 26 and to the other blade assemblies 48, 50.
[0051] Mention is now made to the configuration of the second
translating arm 16. The second translating arm 16 is angled or bent
so as to define a "boomerang" shape--i.e. an elbow or bend 44
between arm segments 42 and 45. Particularly, arm segments 42, 45
are bent to have an internal angle of less than ninety degrees
(angle <90.degree.) with around seventy degrees (70.degree.)
being shown and preferred. Other angles, of course, may be used. A
head 43 is provided at an end of the arm segment 42 opposite the
bend 44 and is angled so as to project essentially parallel with
the arm segment 45. The head 43 holds the blade assembly 52. As
seen, the second translating arm 16 is angled so that its blade
assembly 52 is proximate the blade assembly 48 of the arm 18.
[0052] The second translating arm 16 moves in and out relative to
the housing 32 and thus the second side arm 26 through ratcheting
of the arm segment 45 with its plurality of teeth 47 cooperating
with the ratchet components of the housing 32. Movement of the arm
16 moves the corresponding blade assembly 52 relative to the other
blade assemblies 48, 50. Because of its position and connection
with the housing 32, the second translating arm 16 translates or
moves in the cephalad/caudal directions so that the blade assembly
52 also moves in the cephalad/caudal directions. Position of the
blade assembly 52 affects and effects retraction of tissue at the
surgical site, particularly in the cephalad/caudal directions.
[0053] Ratcheting adjustment of the arm 18 and of the first and
second translating arms 14, 16 (and thus adjustment of the blade
assemblies 48, 50, 52) may be accomplished manually but are
preferably adjusted via one or more surgical instruments or tools.
As such, the arms 18, 24, 26 and the base 13 are configured to
allow manipulation of the arms 18, 24, 26 by a surgical instrument
or tool (not shown).
[0054] As best seen in FIGS. 1 and 4, the arm 18 has a series of
holes 19 that extend along its longitudinal length. The base 13 has
a slot 70 that extends through the housing 28 and which is sized to
receive the arm 18. The arm 18 thus translates within the slot 70.
One or more holes 19 of the arm 18 accepts a surgical instrument,
tool and/or instrument/tool portion to manually move the arm 18
within the slot 70 and in conjunction/cooperation with the
ratcheting housing 28. As should be appreciated, the ratcheting
housing 28 allows incremental locking movement of the arm 18 in one
direction while prohibiting movement in an opposite direction
without the release thereof. In the case of arm 18, the arm 18
incrementally locks in a direction toward the base 13 in order to
hold tissue by the blade assembly 48 in the medial/lateral
direction. This allows the surgeon to incrementally manipulate the
blade assembly 48 and thus the amount of tissue retraction by the
blade assembly 48. Release is accomplished by the button/ratchet
release system 29 associated with the housing/ratchet system 28. As
best seen in FIG. 4, the button 29 extends from the housing 28 into
a configured notch or recess 77 in the first side arm 24. Recessing
the button 29 helps to prevent accidental activation and thus
release of tissue retraction.
[0055] As best seen in FIGS. 1, 3 and 4, the first translating arm
14 has a series of holes 40 that extend along a length of the end
segment 39. In conjunction therewith, the first side arm 24 of the
base 13 has a slot 76 that extends from the configured recess 77
into the housing 30. The slot 76 is sized both in width and length
to fit under the arm segment 39 and particularly under the holes
40. One or more holes 40 of the first translating arm 14 accepts a
surgical instrument, tool and/or instrument/tool portion to
manually move the arm 14 over the slot 76 and in
conjunction/cooperation with the ratcheting housing 30. As should
be appreciated, the ratcheting housing 30 allows incremental
locking movement of the arm 14 in one direction while prohibiting
movement in an opposite direction without the release thereof. In
the case of the first translating arm 14, the arm 14 incrementally
locks in a direction along the longitudinal length of the first
side arm 24 inwardly toward the base 13 in order to hold tissue by
the blade assembly 50 in the cephalad/caudal direction. This allows
the surgeon to incrementally manipulate the blade assembly 50 and
thus the amount of tissue retraction by the blade assembly 50.
Release is accomplished by the button/ratchet release system 31
associated with the housing/ratchet system 30. The button 31
extends outward from the housing 30 helping to prevent accidental
activation and thus release of tissue retraction.
[0056] As best seen in FIGS. 1, 3 and 4, the second translating arm
16 has a series of holes 46 that extend along a length of the end
segment 45. In conjunction therewith, the second side arm 26 of the
base 13 has a slot 74 that extends from proximate an end of the
second side arm 26 near the base 13 and into the housing 32. The
slot 74 is sized both in width and length to fit under the arm
segment 45 and particularly under the holes 46. One or more holes
46 of the second translating arm 16 accepts a surgical instrument,
tool and/or instrument/tool portion to manually move the arm 16
over the slot 74 and in conjunction/cooperation with the ratcheting
housing 32. As should be appreciated, the ratcheting housing 32
allows incremental locking movement of the arm 16 in one direction
while prohibiting movement in an opposite direction without the
release thereof. In the case of the second translating arm 16, the
arm 16 incrementally locks in a direction along the longitudinal
length of the second side arm 26 inwardly toward the base 13 in
order to hold tissue by the blade assembly 52 in the
cephalad/caudal direction. This allows the surgeon to incrementally
manipulate the blade assembly 52 and thus the amount of tissue
retraction by the blade assembly 52. Release is accomplished by the
button/ratchet release system 33 associated with the
housing/ratchet system 32. The button 33 extends outward from the
housing 32 helping to prevent accidental activation and thus
release of tissue retraction.
[0057] As seen in the figures each arm 18, 14 and 16 has a
respective blade assembly 48, 50, 52 for holding and retracting
tissue during spinal surgery. The blade assembly 48 includes a head
54 which pivotally retains a blade holder 57 via an angulation
system controlled by a set screw 66, the head 54 holding a blade
60a. The blade assembly 50 includes the head 37 which pivotally
retains a blade holder 56 via an angulation system controlled by a
set screw 67, the head 37 holding a blade 60b. The blade assembly
52 includes the head 43 which pivotally retains a blade holder 58
via an angulation system controlled by a set screw 68, the head 43
holding a blade 60c. The blades 60a, 60b and 60c are preferably,
and as shown, identical. While each blade assembly 48, 50, 52 is
identical, one or more blade assembly may be different as desired.
However, in the preferred embodiment as shown, the three blade
assemblies forming a triangular blade assemblage, are identical and
fashioned in accordance with the present principles. Therefore,
description of one blade assembly of the blade assemblies 48, 50,
52 describes the others of the blade assemblies 48, 50, 52.
Moreover, the description of one blade 60a, 60b, 60c of the blade
assemblies 48, 50, 52 describes the others of the blades 60a, 60b,
60c. In general, the blade assemblies 48, 50, 52 are each designed
for up/down or posterior/anterior translation or angulation. In
FIGS. 1, 2 and 4, the blade assemblies 48, 50, 52 are in a
0.degree. or non-angulated position as well as in an un-retracted
position. In FIG. 3, the blade assemblies 48, 50, 52 are in a
downwardly angled position (an angle downwardly from 0.degree.) as
well as in a retracted position.
[0058] With particular reference to FIG. 5 the details of a blade
assembly and blade will be described with reference to blade
assembly 50. As seen, the blade holder 56 is shown in a 0.degree.
position wherein the blade 60b is in a full upright or vertical
position. The blade holder 56 is pivotally coupled to the head 37.
Particularly, an end or tongue 88 of the blade holder 56 is
received within a cutout 86 of the head 37 and pivotally connected
at sides thereof to arms 84 and 85 of the head 37. This allows the
blade holder 56 to pivot relative to the head 37. The blade holder
56 and the head 37 are connected via the angulation adjustment
system 63 which includes a worm gear system driven by the hex nut
67. Particularly (and in conjunction with FIG. 3) the hex nut 67 is
externally threaded to mesh with screw serrations 80 on an end of
the blade holder 56. As the hex nut 67 is rotated clockwise or
counterclockwise the blade holder 56 will angulate or pivot up and
down. As the blade holder 56 angulates or pivots downward, the
spade portion 61b of the blade 60b moves outwardly (medially or
laterally) to effect splaying of the tissue. As seen in FIG. 3, the
blade holder 58 includes screw serrations 82 on an end thereof as
part of its angulation adjustment system 59.
[0059] The blade holder 56 has first and second side arms 90, 91
that define a configured notch 94 that is adapted to receive a
configured flange 96 of a head 95 of the blade 60b. The blade
holder 56 and the blade 60b are configured to allow the blade 60b
to be positively received and held, removed and replaced. Inwardly
projecting ends 92, 93 of the first and second side arms 90, 91
define a confined slot for receipt and retention of the blade head
96, the blade flange 96 having lips 97, 98 for complementary
reception by the ends 92, 93. The blade 60b is thus vertically
inserted into and removed from the blade holder 56.
[0060] The blade holder 56 incorporates a spring loaded detent
system 79 which releasably locks the blade 60b into the blade
holder 56. The blade 60b has a keyed access point 62b to allow both
insertion of the blade 60b into the blade holder 56 as well as
actuation of the detent system 79 in order to release the blade 60b
from the blade holder 56.
[0061] The blade 60b has a tong, spade, paddle or the like 61b that
extends transverse from the head 95. An inner surface 99 of the
paddle 61b is curved inwardly (i.e. concave relative to the head
95). A channel 100 extends from a top of the paddle 61b (i.e. the
top of the concavity 99) to an end of the paddle 61b. The channel
100 receives a shaft that permits anatomical docking of the blade
to bony anatomy and/or a cannula in which lighting may be inserted
to aid in intraoperative visualization. Rounded corners permit the
finestra formed by the blades 60a, 60b, 60c to maintain the same
diameter as the blades are angulated.
[0062] It should be appreciated that the present spinal retractor
10 provides a table mount connection to secure retractor position
relative to the patient via the frame (table). The cephalad/caudal
translating arms incrementally lock positions via ratcheting teeth
within each ratchet housing and subsequently expand both soft
tissue retraction by means of the blades. Each translating arm can
be moved independently. The cephalad/caudal translating arms
cooperate and co-act with the medial/lateral translating arm to
provide a stable finestra and retraction. Thumb actuated depressors
release the locked positions of the arms and thus the blades.
Adjustable convergence of each translating arm 14, 16, 18 with
respective blades creates an adjustable finestra to the surgical
site.
[0063] Referring now to FIGS. 6-21C, a spinal retractor assembly
210 is shown according to one embodiment. As discussed in greater
detail below, retractor assembly 210 may share various functional
and structural features with spinal retractor 10. In one
embodiment, retractor assembly 210 includes a frame or base 212
(e.g., a plate, frame, or base assembly, etc.), a first side
assembly 214, a second side assembly 216, and a center assembly
218. Assemblies 214, 216, and 218 are coupled to base 212 to enable
translating movement of assemblies 214, 216, 218 relative to base
212 to provide retraction of tissue, etc. during surgical
procedures involving the spine, etc. First and second side
assemblies 214, 216 translate relative to frame 212 in a
medial-lateral direction (e.g., along a first axis or direction),
and center assembly 218 translates relative to frame 212 in a
cephalad-caudal direction (e.g., along a second axis or direction)
in a generally perpendicular fashion relative to first and second
assemblies 214, 216. In one embodiment, each of assemblies 214,
216, 218 may be adjusted (e.g., translated) relative to frame 212
independently (e.g., such that each of assembly 214, assembly 216,
and assembly 218 may be adjusted individually).
[0064] Referring to FIGS. 6 and 10, frame 212 includes body 220, a
first side adjustment member or knob 222, a second side adjustment
member or knob 224, and a center adjustment member or knob 226.
Knobs 222, 224 are coupled to drive members 223, 225, respectively,
such that rotation of knobs 222, 224, causes a corresponding
rotation of drive members 223, 225. Drive members 223, 225 include
bevel gears in one embodiment and, as discussed in greater detail
below, are configured to engage bevel gears on corresponding
adjustment members. Knob 226 may be coupled to a drive member of
similar structure and function.
[0065] In one embodiment, frame 212 further includes table arm
mounts 228, 230, 231 (see FIG. 7). Mounts 228, 230, 231 are
configured to enable attachment of retractor assembly 210 to a
table arm in a fixed relationship. As such, retractor assembly 210
may be fixed in space via one or both of table mounts 228, 230,
231. Mounts 228, 230, 231 may be located in any suitable locations,
and more or fewer mounts may be provided than illustrated according
to various alternative embodiments.
[0066] Referring FIGS. 9-10 and 14, in some embodiments frame 212
includes first and second side retainers 232, 234. Side retainers
are positioned at the lateral ends of frame 212 and form at least a
portion of the channels within which assemblies 214, 216 translate.
In one embodiment, retainers 232, 234 define a limit to the range
of motion of first and second side assemblies 214, 216. Retainers
232, 234 may be coupled to body 220 using any suitable fastening
technique, including welding, press fits, mechanical fasteners, and
the like. As shown in FIG. 14, a center retainer 236 similarly is
coupled to a center portion of body 220 using any suitable
fastening technique, including welding, press fits, mechanical
fasteners, and the like.
[0067] In some embodiments, retaining pins 238 extend through body
220 and, as discussed in greater detail below, are received within
annular grooves in threaded members to hold the threaded members in
position during use of retractor assembly 210. In one embodiment,
three retaining pins 238 are utilized. In other embodiments, more
or fewer retaining pins may be used. Further, marker pins 240 may
be used in connection with each of first side assembly 214, second
side assembly 216, and center assembly 218. Marker pins 240 extend
up from assemblies 214, 216, and 218 and through body 220 to
provide an indication of the positions of assemblies 214, 216, and
218 relative to body 220, thereby providing a user of retractor
assembly 210 a visual indication of the amount of retraction being
provided by each of assemblies 214, 216, and 218. In one
embodiment, body 220 includes marking gauges 254 (see FIG. 7)
having incremental distance markings to provide further information
regarding amounts of retraction. Thus, the amount of retraction is
indicated by the position of the marking pins 240 along marking
gauges 254.
[0068] In one embodiment, body 220 includes a first lateral
extension 242, a second lateral extension 244, and a central
extension 246 (see FIG. 9). First and second lateral extensions
242, 244 generally extend along a common first axis, and central
extension 246 generally extends along a second axis perpendicular
to the first axis. Central extension 246 is in one embodiment
positioned at approximately the midpoint between the opposite ends
of first and second lateral extensions 242, 244. A first lateral
channel 248 is formed in first lateral extension 242, a second
lateral channel 250 is formed in second lateral extension 244, and
a central channel or bore 252 is formed in central extension 246.
Channels 248, 250, 252 receive end portions of first side assembly
214, second side assembly 216, and center assembly 218,
respectively. A first side adjustment aperture 256 is provided on
first lateral extension 242, a second side adjustment aperture 258
is provided in second lateral extension 244, and a center
adjustment aperture 260 is provided in center extension 246.
Adjustment apertures 256, 258, 260 are configured to receive
adjustment knobs and/or drive members to enable user-adjustment of
first side assembly 214, second side assembly 216, and center
assembly 218 relative to body 220.
[0069] Referring to FIG. 10, translation of first and second side
assemblies 214, 216 is accomplished via rotation of adjustment
knobs 222, 224. Adjustment knobs 222, 224 are coupled to drive
members 223, 225, which may include bevel gears. Drive members 223,
225 in turn engage bevel gears 267, 269 provided on opposing ends
of threaded adjustment members 270, 271, such that rotation of
knobs 222, 224 causes a corresponding rotation of adjustment
members 270, 271. First and second side assemblies 214, 216 are
threadingly received by adjustment members 270, 271 such that
rotation of adjustment members 270, 271 causes translation of first
and second side assemblies 214, 216. Central assembly is movable in
a similar fashion, through use of adjustment knob 226 and
adjustment member 342. As such, through selective rotation of knobs
222, 224, and 226, first and second side assemblies 214, 216 and
central assembly 218 may be translated independently from one
another relative to body or frame 212.
[0070] Referring to FIGS. 11-13, assembly 210 is movable between a
closed configuration, shown in FIG. 11, to an open configuration,
shown in FIG. 12, through translation of first and second side
assemblies 214, 216 and/or central assembly 218 relative to body
220. Furthermore, first and second side assemblies 214, 216 and
central assembly 218 receive blade assemblies 282, 316, and 348,
respectively, which are configured to hold tissue apart during
various procedures. As shown in FIGS. 12 and 14 and as discussed in
greater detail below, blade assemblies 282, 316, 342 may be
angulated (e.g., moved from a generally vertical orientation to one
or more non-vertical, or angled, orientations) to suit a particular
procedure.
[0071] Referring now to FIGS. 15A-15B, first side assembly 214 is
shown in greater detail according to one embodiment. Assembly 214
includes a first arm portion 262 coupled to a second arm portion
264. First arm portion 262 and second arm portion 264 can take any
suitable size and/or shape, and be coupled together using a variety
of coupling methods.
[0072] In one embodiment, first arm portion 262 is translatable
relative to frame 212, but rotatably fixed relative to frame 212,
and second arm portion 264 is rotatably coupled to first arm
portion 262. As shown in FIGS. 18A-19B, second arm portion rotates
relative to first arm portion 262 about a first pivot pin 266. An
adjustment knob 278 is coupled to an insert 279 which threadingly
engages an angulation adjustment member 276. Member 276 includes a
threaded shaft and rotates about a second pivot pin 268. As shown
in FIGS. 18A-19B, as a user turns knob 278, the angular position of
second arm portion 264 relative to first arm portion 262 changes
due to the travel of insert 279 along member 276, providing angular
adjustability of the associated blade assemblies. For example, as
shown in FIGS. 18A-B, first and second arm portions 262, 264 are
generally aligned, and knob 278 is in a first position. Upon
turning knob 278, knob 278 moves to a second position, shown in
FIGS. 19A-B, and second arm portion 264 moves to an angulated
position with respect to first arm portion 262, thereby enabling
additional retraction of surrounding tissue, etc.
[0073] Referring to FIG. 15A, first arm portion 262 includes an
internally threaded cylindrical portion 284. Portion 284 is
received within channel 248 and translates therein. In some
embodiments, the outer contour of portion 284 generally corresponds
in shape to the inner contour of channel 248 such that portion 284
is limited to translational movement within channel 248. In one
embodiment, portion 284 is received within bushings 300, 302, which
are provided on threaded member 270 and may act to enable rotation
of threaded member 270 within channel 248 and/or define the range
of motion of portion 284. First arm portion 262 further includes
pin apertures 286, which are sized and shaped to receive first and
second pivot pins 266, 268. In order to provide the angulation of
second arm portion 264, first arm portion 262 further includes an
adjustment surface 288. As shown in FIGS. 18A and 19A, adjustment
surface 288 in one embodiment limits the total amount of angulation
of second arm portion 264 relative to first arm portion 262.
[0074] Second arm portion 264 includes a blade receiving portion
292 and a blade lock bore 294. Blade receiving portion 292 is
configured to receive first side blade assembly 282, and blade lock
bore 294 is configured to receive blade lock 280. In one
embodiment, blade lock 280 includes a non-circular head such that
blade lock 280 is rotatable within blade lock bore 294 into and out
of an interfering position relative to first side blade assembly
282 when first side blade assembly 282 is received within blade
receiving portion 292. As such, first side blade assembly 282 may
be slidingly received within blade receiving portion 292 and
subsequently maintained in position relative to second arm portion
264 by way of blade lock 280.
[0075] Second side assembly 216 in one embodiment operates in a
similar manner to first side assembly 214, and includes similar
components, including a first arm portion 296 and a second arm
portion 298, which receives second blade assembly 316.
[0076] Referring to FIGS. 16A-16B, center assembly 218 includes a
first arm portion 330 and second arm portion 332 pivotally coupled
to first arm portion 330 via pivot pins 336. An angulation knob 334
threadingly engages an adjustment member 342 to cause rotation of
adjustment member 342 about angulation pivot pin 338. Center blade
assembly 342 is received by second arm portion 332 and retained in
place by a blade lock 346. Rotation of adjustment knob 344 causes a
corresponding change in the angulation of center blade assembly
342.
[0077] Referring now to FIG. 17, in one embodiment, blade
assemblies 282, 316, 342 form a circular interior when spinal
retractor 210 is in the closed position and blade assemblies 282,
316, and 342 are in a non-angulated orientation. Dependent upon a
desired type and degree of distraction, the various side and center
assemblies and blade assemblies may be moved to desired positions
to provide the desired retraction for a particular procedure.
[0078] Referring to FIGS. 20A-21C, a blade assembly 400 is shown
according to an alternative embodiment. The features of blade
assembly 400 may be implemented with any of blade assemblies 282,
316, and 342. In one embodiment, blade assembly 400 includes a
blade support 402 coupled to a primary blade 404. A secondary blade
406 is removably and adjustably coupled to primary blade 404 via a
ratchet mechanism 408. One or more channels 410 may be provided in
primary blade 404 to enable insertion of light sources, fixation
pins, or other components. For example, in some embodiments, upon
positioning blade assembly 400 in a desired retraction position,
one or more fixation pins may be placed within channel 410 to
secure the blade(s) in place. Use of secondary blade 406 is in some
embodiments optional, and enables, for example, prevention of
tissue creep during procedures and eliminated the need to change to
a longer blade during a procedure.
[0079] In use, spinal retractor 210 is positioned at a desired
position relative to a patient, and may be secured using one or
more of table arm mounts 228, 230, 231. Spinal retractor 210 is
normally initially in a closed configuration (see, e.g., FIG. 11).
Spinal retractor may be moved to a desired open configuration by
translating one or more of first side assembly 214, second side
assembly 216, and center assembly 218 relative to base 212.
Further, one or more of blade assemblies 282, 316, or 342 (or
similarly, blade assembly 400), may be angulated into a desired
position of angulation. In some embodiments, a secondary blade may
be utilized to prevent tissue creep during a procedure, and one or
more components (e.g., lights, fixation pins, etc.) may be utilized
via one or more of the blade assemblies.
[0080] Referring now to FIGS. 22-32C, a spinal retractor 510 is
shown according to another alternative embodiment. The spinal
retractor 510 shown in FIGS. 22-30 shares many of the features of
the spinal retractors shown in FIGS. 1-5 and 6-21, and all such
features are understood to be part of the embodiment shown in FIGS.
22-30.
[0081] Referring to FIGS. 22-24, the spinal retractor 510 includes
a frame or base 512, a first side assembly 514, a second side
assembly 516, and a center assembly 518. The first side assembly
514, the second side assembly 516, and the center assembly 518 are
coupled to the base 512 to enable translating movement of the
assemblies 514, 516, and 518 relative to the base 512 to provide
retraction of tissue, etc. during surgical procedures involving the
spine, etc. The first side assembly 514 and the second side
assembly 516 translate relative to the base 512 in a medial-lateral
direction (e.g., along a first axis or direction), and the center
assembly 518 translates relative to the base 512 in a
cephalad-caudal direction (e.g., along a second axis or direction)
in a generally perpendicular fashion relative to the first and
second side assemblies. In one embodiment, each of the assemblies
514, 516, 518 may be adjusted (e.g., translated) relative to the
base 512 independently (e.g., such that each of the first side
assembly 514, the second side assembly 516, and the center assembly
518 may be adjusted individually).
[0082] The base 512 includes a body 520, a first side adjustment
knob or member 524, a second side adjustment knob or member 526,
and a center adjustment knob or member 528. The first side
adjustment knob 524 is operatively coupled to the first side
assembly 514, the second side adjustment knob 526 is operatively
coupled to the second side assembly 516, and the center adjustment
knob 528 is operatively coupled to the center assembly 518, such
that adjustment of knobs 524, 526, 528 causes a corresponding
translational movement of the assemblies 514, 516, 518.
[0083] Referring to FIGS. 25-26, the first side adjustment knob 524
is coupled to a first threaded shaft 535 via a first side drive
assembly 534, the second side adjustment knob 526 is coupled to a
second threaded shaft 537 via a second side drive assembly 536, and
the center adjustment knob 528 is coupled to a third threaded shaft
539 via a center drive assembly 538. The first side drive assembly
534, second side drive assembly 536, and center drive assembly 538
are similar in structure and function, and therefore only first
side drive assembly 534 will be discussed in detail with respect to
FIG. 26. However, it should be understood that any features shown
and described with respect to the first side drive assembly 534 are
equally applicable to the second side drive assembly 536 and the
center drive assembly 538.
[0084] As shown in FIG. 26, the first side drive assembly 534 is
operatively coupled to the first threaded shaft 535 via a first
multi-axis joint assembly, shown as ball joint assembly 540. The
first threaded shaft 535 is received in a bore 541 in the first
side assembly 514. The first threaded shaft 535 engages one or more
elements, shown as pins 543, that extend into the bore 541. Through
the interaction between the pins 543 and the first threaded shaft
535, the first threaded shaft 535 advances into or withdraws from
the bore 541 as the first threaded shat 535 is rotated. In other
embodiments, the first threaded shaft 535 may otherwise engage the
bore 541 in the first side assembly 514. For example, the bore 541
may be formed with an internal thread configured to engage the
first threaded shaft 535.
[0085] The ball joint assembly 540 includes a drive shaft 542
pivotally coupled at a first end to the first side adjustment knob
524 by a pivot pin 544. The second end of the drive shaft 542 is in
the form of a ball 546 that is adjustably coupled to a receiver 548
via a cross pin 550. The ball 546 defines a slot 552 sized to
receive the cross pin 550 such that the drive shaft 542 can pivot
about multiple axes (e.g., such that the first end of the drive
shaft 542 is rotatable through a semi-spherical range of motion).
For example, in a non-rotated position, the drive shaft 542 extends
generally collinearly with the first threaded shift 535. When put
into the position shown in FIG. 25, the drive shaft 542 is able to
rotate about both the X-axis 554 and the Z-axis 556 shown in FIG.
25. Providing an angular offset for the drive shaft 542, and in
turn, the first side adjustment knob 524, may provide a more
advantageous position for adjusting the spinal retractor 510. In
some embodiments, the first side drive assembly 534 is operatively
coupled to the first threaded shaft 535 via another moveable
coupling member that allows the drive shaft 542 to pivot about
multiple axes (e.g., such that the first end of the drive shaft 542
is rotatable through a semi-spherical range of motion). For
example, in some embodiments, the first side drive assembly 534 may
be operatively coupled to the first threaded shaft 535 via a
universal joint mechanism. Other types of multi-axis joints or
coupling mechanisms may be used according to various alternative
embodiments.
[0086] The spinal retractor 510 is movable between a closed
configuration, shown in FIG. 22, to an open configuration, through
translation of the first side assembly 514 and the second side
assembly 516 and/or the center assembly 518 relative to the body.
Furthermore, the first side assembly 514, the second side assembly
516, and the center assembly 518 receive blade assemblies 515,
which are configured to hold tissue apart during various
procedures. The blade assemblies 515 may be angulated (e.g., moved
from a generally vertical orientation to one or more non-vertical,
or angled, orientations) to suit a particular procedure. The first
and second side assemblies and the center assembly may further
include first and second portions such as those described with
respect to FIGS. 15A-16B to provide further adjustment capabilities
for the spinal retractor 510.
[0087] Referring now to FIGS. 27-30, the spinal retractor 510 is
shown coupled to one or more handles. For example, as shown in FIG.
27, a first adjustment handle 564 is coupled to the first side
adjustment knob 524, a second adjustment handle 566 is coupled to
the second side adjustment knob 526, a third adjustment handle 568
is coupled to the center adjustment knob 528, and a support handle
562 is coupled to the base 512. The various handles are in one
embodiment attached in a removable fashion such that the handles
can be selectively attached/detached during use of the spinal
retractor 510.
[0088] As shown in FIGS. 28 and 29, the support handle 562 is
coupled to the base 512 adjacent the center adjustment knob 528.
The support handle 562 defines a plurality of grip portions 570 and
a central aperture 572. In one embodiment, the support handle 562
is a substantially rigid member, while in alternative embodiments,
the support handle 562 is a flexible and/or compressible member
(e.g., such that the opposing sides of the support handle 562 are
deformable inward toward each other). In some embodiments, the grip
portions 570 are shaped to generally correspond to the shapes of
the fingers of a user to prevent slippage between the spinal
retractor and a hand of a user.
[0089] Referring to FIG. 29, in one embodiment, the support handle
562 includes a handle attachment portion 574 that is received in a
groove 275 in the base 512 (see FIG. 22). As such, the support
handle 562 may be slidably attached and detached relative to the
base 512. As shown in FIG. 29, the attachment portion 574 includes
a locking plate 576 defining a button 578 and projection 580. The
locking plate 576 is received by the groove 275, and a pair of
springs 582 bias the projection 580 into a recess 584 formed in the
base 512 (e.g., as part of the groove 275). A pair of guide pins
586 received in slots 588 in the locking plate 576 maintain proper
alignment of the locking plate 576. Depression of the button 578
disengages the projection 580 from the recess 584 and enables
detachment of the support handle 562 from the base 512.
[0090] Referring to FIG. 30, the first adjustment handle 564 is
shown removed from the first side adjustment knob 524. When the
first adjustment handle 564 is detached, the first side adjustment
knob 524 is free to rotate about the pivot pin 544. When the first
adjustment handles 564 is attached, one or more flat portions 590
on the drive shaft 542 interface one or more flat portions 592 on
the first adjustment handle 564 to resist rotation of the first
side adjustment knob 524 relative to the drive shaft 542. In one
embodiment, when the first adjustment handle 564 is coupled to the
first side adjustment knob 524, the first adjustment handle 564
extends in a direction generally collinear with the axis of the
drive shaft 542. In other embodiments, the first adjustment handle
564 may extend in other directions. The first adjustment handle 564
defines a slot 594 in which the first side adjustment knob 524 is
received. A protrusion within the slot 594 engages a corresponding
channel 596 to align the first adjustment handle 564 with the first
side adjustment knob 524 and limits the movement of the first
adjustment handle 564 with respect to the first side adjustment
knob 524.
[0091] Referring to FIGS. 31A-32C, a blade assembly 600 is shown
according to one embodiment. The blade assembly 600 may be similar
in construction and features to the blade assembly 400 and may be
implemented with any of blade assemblies 282, 316, 342, and 400. In
one embodiment, blade assembly 600 includes a blade support 602
coupled to a primary blade 604. A secondary blade 606 is removably
and adjustably coupled to primary blade 604 via a ratchet mechanism
608 (e.g., using one or more projections that are biased into one
or more recesses to provide adjustable positioning of the secondary
blade 606). One or more channels 610 may be provided in primary
blade 604 to enable insertion of light sources, fixation pins, or
other components. For example, in some embodiments, upon
positioning blade assembly 600 in a desired retraction position,
one or more fixation pins may be placed within channel 610 to
secure the blade(s) in place. Use of secondary blade 606 is in some
embodiments optional, and enables, for example, prevention of
tissue creep during procedures and eliminated the need to change to
a longer blade during a procedure.
[0092] It should be understood that the spinal retractor shown in
FIGS. 22-30 may share any or all of the features described
elsewhere herein, including blade extenders/supplemental blades,
blade locking features, lighting features extending within channels
in the blades, and the like. All such combinations of features are
to be understood to be within the scope of the present
disclosure.
[0093] In one embodiment, in operating a spinal retractor such as
one described herein, the retractor is placed into a desired
position. A first side assembly, a second side assembly, and a
center assembly of the retractor are translated along threaded
shafts relative to a frame of the retractor. The side and center
assemblies may be translated via manipulation of ball joint
assemblies that couple adjustment knobs to the respective threaded
shafts.
[0094] The spinal retractor shown and described herein may provide
various benefits over more traditional designs. The support handle
provides a modular, ergonomic handle for improved manipulation of
the base or frame to ease alignment of the device, and the
adjustment handles provide modular ergonomic handles for
translation of the side and center assemblies without the need for
additional instrumentation. Further, the adjustment handles
stabilize the positions of the adjustment knobs for ease of use.
The gear rations of the threaded shafts provide faster translation
of components (e.g., twice as fast as certain conventional device)
such that each of the side and center assemblies can be completely
expanded with 1.5 revolutions of the threaded shafts/adjustment
knobs.
[0095] Additionally, the frame weight is less compared to more
traditional devices (e.g., by 15 percent or more), and the frame
geometry is optimized to enable table arm attachment to the center
arm assembly while eliminating interference with the base or frame
(e.g., in situations when the table arm extends generally parallel
to the length of the frame or base). In some embodiments, blade
extenders include self-retaining springs to ensure the blade
extenders remain captured within the blades, and the blade locking
mechanisms provide a spring-activated locking feature requiring
only a one quarter turn to lock/unlock the blades. Further, light
sources may extend down channels in the blades to provide optimized
lighting (e.g., 15 percent or more light output relative to more
traditional designs).
[0096] While the invention has been illustrated and described in
detail in the drawings and foregoing description, the same is to be
considered as illustrative and not restrictive in character, it
being understood that only a preferred embodiment has been shown
and described and that all changes and modifications that come
within the spirit of the invention are desired to be protected.
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